| NPI | 1457927196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01809) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: VA 0103301436) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2026-04-11 |